Individual provider Active NPI

Mary Beth Major, NP-C

  • Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1821550591
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
6523 Issued in MN
Practice address
3427 1St Ave S
Minneapolis, MN 55408-4506
Phone
(612) 805-2320
NPI assigned
Apr 2, 2019
Last updated
Mar 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 6523 MN Primary
Gerontology Nurse Practitioner 363LG0600X 6523 MN

Addresses

Primary practice location

3427 1St Ave S
Minneapolis, MN 55408-4506

Mailing address

3427 1St Ave S
Minneapolis, MN 55408-4506
Phone (612) 805-2320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190618000498 MN Practitioner - Nurse Practitioner 1951634310 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illumia Health LLCGroup PAC ID 7810424306, 33 clinicians

Practice addresses (Care Compare)

3580 Linden Ave
Suite A1
White Bear Lake, MN 55110-4625
Phone (763) 326-2996

Merit-based Incentive Payment System (MIPS)

Final score
87.25 of 100Reported as group
Quality
60.43
Promoting interoperability
83
Improvement activities
40
Cost
79.28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
6523MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespark Medical Group, PA Gerontology CurrentSince Mar 20, 2023 Accepting new patients
Illumia Health LLC CurrentSince Jun 14, 2025 Accepting new patients

Locations

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

5320 W 23rd St
Ste 130
St Louis Park, MN 55416
Phone (952) 345-3213

3580 Linden Ave
Ste A1
White Bear Lk, MN 55110
Phone (651) 633-6522

655 Brawley School Rd
Ste 200
Mooresville, NC 28117

Interoperability endpoints

  • Direct secure messaging: mary.beth.major.1@15699.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1821550591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3427 1ST AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554084506",
            "telephone_number": "612-805-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3427 1ST AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554084506",
            "telephone_number": "612-805-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAJOR",
        "first_name": "MARY",
        "middle_name": "BETH",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "6523",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "6523",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.